20% rise in those having unprotected sex

Information from the CDC shows that the number of men who have sex with men having unprotected sex has steadily been increasing from 2005, and continuing through 2011 (the last year that the figures were reported for).

The term “men who have sex with men,” or MSM, includes gay and bisexual males, and men who do not consider themselves gay or bisexual but do have sex with other men.

Presumably, the trend is continuing. The percentage increase in those having unprotected sex was almost 20%. Of course, this increases the risk for the transmission of HIV. Other data from the same study shows that only about 67% of MSMs get tested yearly for HIV.

AIDS ribbon via Shutterstock

AIDS ribbon via Shutterstock

Why is the incidence of unprotected sex steadily increasing considering that it greatly increases the risk for acquiring HIV?

The CDC presents the following as some possible reasons for the worsening data.

* In spite of CDC recommendations that MSMs get tested yearly for HIV*, only about 67% do so. The problem? Someone sexually active who has tested negative for HIV only six months ago, could now be HIV positive. So men, believing themselves to be HIV negative, may be positive and capable of spreading HIV unknowingly. And these men, as well as those who don’t get tested at all, or who are HIV positive and not taking antiretrovirals, may have a very high viral load. So, even when men try to serosort (have sex only with the same HIV status partner), they may be actually having sex with a serodiscordant partner.

* Some men may not disclose that they are HIV positive to prospective partners.

* Others may say that they will use a condom, but then do not do so.

* Other CDC data has shown that having sex under the influence of drugs and/or alcohol makes the prospective partners more likely to have unprotected sex.

* Some MSMs feel that their risk of getting HIV is much lower than it is in reality.

*Some feel that HIV is easily manageable and no longer a major health problem.

* There are some men who don’t ask each other what their HIV statuses are. The CDC estimates that anywhere from 15% to 18% of people with HIV are unaware that they have HIV.

Between 2008 and 2010 the incidence of new cases of HIV in MSMs increased by about 12%. That’s about 3,000 more men who now have HIV over the approximately 30,000 men who acquired HIV in 2010. The highest incidence of new HIV infections is in the range of ages 13-34.

Some good news, the number of new HIV infections in women decreased by about 20%, from around 12,000/year down to around 9,500/year.

Some additional background on HIV in the US, from the CDC:

• More than 1.1 million people in the United States are living with HIV infection, and almost 1 in 6 (15.8%) are unaware of their infection.
• Gay, bisexual, and other men who have sex with men (MSM), particularly young black/African American MSM, are most seriously affected by HIV.
• By race, blacks/African Americans face the most severe burden of HIV.

The CDC estimates that 1,144,500 persons aged 13 years and older are living with HIV infection, including 180,900 (15.8%) who are unaware of their infection. Over the past decade, the number of people living with HIV has increased, while the annual number of new HIV infections has remained relatively stable. Still, the pace of new infections continues at far too high a level— particularly among certain groups.

HIV Incidence (new infections): The estimated incidence of HIV has remained stable overall in recent years, at about 50,000 new HIV infections per year. Within the overall estimates, however, some groups are affected more than others. MSM continue to bear the greatest burden of HIV infection, and among races/ethnicities, African Americans continue to be disproportionately affected.

HIV Diagnoses (new diagnoses, regardless of when infection occurred): In 2011, an estimated 49,273 people were diagnosed with HIV infection in the United States. In that same year, an estimated 32,052 people were diagnosed with AIDS. Overall, an estimated 1,155,792 people in the United States have been diagnosed with AIDS.

Deaths: An estimated 15,529 people with an AIDS diagnosis died in 2010, and approximately 636,000 people in the United States with an AIDS diagnosis have overall. The deaths of persons with an AIDS diagnosis can be due to any cause—that is, the death may or may not be related to AIDS.
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* A number of others (physicians, researchers, some other agencies, HIV clinics, etc.) feel strongly that HIV testing in sexually active MSMs should be more often than just yearly.


Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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  • http://www.herpeswoo.com/ HerpesWoo.com

    So, protected sex is very important.

  • http://www.herpeswoo.com/ HerpesWoo.com

    So, Unprotected sex is very important.

  • http://adgitadiaries.com/ karmanot

    Absolutely. I am still haunted by the faces and the deaths at which I attended.

  • Mike_in_the_Tundra

    They need to know those stories. They need to understand why our generation was decimated. They need to feel what it was like to carry a friend from one room to another. I’m sorry to be such a downer, but I keep seeing a friend’s face.

  • docsterx

    You’re right, I think it has to do with a number of factors, not just that HIV is “tamed.” Others here have mentioned the AIDS deaths that took place before antiretrovirals. The 13+ year-olds never saw that. People see antiretrovirals advertised and think that a pill or two makes everything OK.

    Years ago the CDC found that there are men out there who may rarely have sex with other men. Virtually none of those men considered themselves gay or bisexual. So even those who were aware of the risks of gay sex, they didn’t think it applied to them because they weren’t “gay” (or bisexual).

    A small percentage of the population is unaware of how HIV spreads. Some don’t care to get tested; some don’t want to know what their status is. Some haven’t learned much about HIV in school or on the net and are unfamiliar with how serious it is. Some don’t look at the other diseases that can develop in patients with HIV: increased heart attack risk in some, infections, other chronic medical conditions, etc. Some don’t have access to health care and/or testing sites. Some people don’t think heterosexuals can get HIV. To them, only gays and IV drug abusers are at risk. Sexual encounters that take place while the participants are under the influence of drugs and/or alcohol tend to be higher risk situations. And there are others, too. Mike_in_the_Tundra (below) adds another good example.

  • http://adgitadiaries.com/ karmanot

    “there has to be something going on there” —- a major one is the ‘down low’ which is decimating women and families of color as among the highest risk demographics. This trend can be laid directly on the doorstep of the Southern Baptist cults, who refuse to recognize the dangers of their denial and religious condemnation.

  • http://adgitadiaries.com/ karmanot

    The unbelievable horrors we experienced and witnessed —— nobody wants to know the stories now.

  • Bill_Perdue

    Fools.

  • http://AMERICAblog.com/ John Aravosis

    Yep, that mixed with their friends are dropping dead like ours did.

  • ComradeRutherford

    I slammed my dick in a car door once.

    It was OK. I was wearing a condom and didn’t feel a thing!

  • Drew2u

    “So there are a lot more complex factors involved.”
    As there always are; we don’t live in a bumper-sticker world where Right/Wrong is divided along a delineation and all bad guys where horizontal-striped shirts, black eye-masks, and carry $$-sacks.
    Unfortunately a lot of people (especially if you tune to FOX) bellow that fantasy as proof and fact.

  • S1AMER

    Dumb. Dumb, dumb, dumb, dumb.

    Oh, you can say “we” (i.e., our community, society generally, the medical profession, etc.) are not doing an adequate job of educating people. Perhaps, perhaps.

    But mostly, we’re talking just plain dumb.

  • Mike_in_the_Tundra

    We all went through a period of time when we thought we were invincible. Then life got in the way.

  • http://www.americablog.com/ Naja pallida

    That was basically my thought. Reading further on the CDC site, seems like STDs are up across the board for people, 20-25. Which I can only attribute to lack of education among those people who were in middle and high school when so many states started with abstinence only education. Of course, one could point to the teen pregnancy rate declining for years as evidence that it has been working. So there are a lot more complex factors involved.

  • Mike_in_the_Tundra

    If they could just see some of the things I saw in the 80s, such as watching a friend waste away, they would think about it. It’s very difficult to be intimate with someone who is too weak to raise their head off a pillow.

  • mirror

    Intimacy involving unprotected without even an inquiry as to one’s partner’s HIV status is very much like driving drunk.

  • Drew2u

    A broader acceptability of being gay + general lack of sex education + instant social media = more kids that don’t know what they’re doing ?

  • devlzadvocate

    No shit. Naja pallida said there has to be something going on there. You said they are tired of thinking about it and want to be intimate. I am just saying there are a whole bunch of things happening IN ADDITION to wanting to be intimate. There are other thought processes besides being intimate that contribute to the increase. I am not comparing intimacy to driving in any condition. I am adding circumstances that may contribute to the increase in numbers.

  • http://twitter.com/rickroberts Rick Roberts

    Intimacy is different from driving while drunk.

  • devlzadvocate

    Yeah, I guess that is part of it, but I would also guess it is the same human thinking that comes with texting while driving, driving drunk, smoking, unplanned pregnancies and other high risk behaviors. That thinking usually involves, ” . . . it won’t happen to me”, ” . . . just this once”, ” . . . I’ll stop soon” and “the heat of the moment”.

  • http://twitter.com/rickroberts Rick Roberts

    Yeah, they are sick of fucking thinking about it and want to be intimate.

  • http://www.americablog.com/ Naja pallida

    A rather disturbing trend… but I have trouble believing that it is simply be because the specter of HIV/AIDS has been diminished. I get that much of the younger generation have never felt the dread of HIV, but there has to be something else going on there.

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